Stroke by Carotid Dissection in the postpartum about 4 cases in the Neurology Department of the Nouakchott Hospital Center (Mauritania).

Abstract

Introduction: Carotid dissections are acute accidents characterized by the presence of a hematoma in the arterial wall. They cause a signi icant reduction in the caliber of the artery thus drastically reducing the cerebral perfusion downstream. They are responsible for about 20% of infarcts in subjects under 45 years of age. Classically, a notion of cervical trauma is found in the immediate antecedents. More rarely are dissection after exercise. It is in this context we meet the dissections post deliveries Observations : We present four observations retrospectively hospitalized in the neurology department of the Nouakchott Hospital Center for Ischemic Stroke on carotid dissection during childbirth. Discussion : The patients are 27 to 36 years of age, without previous medical history, referred due to motor de icit with headache in 4 postpartum patients. Three of them had language problems. Cerebral CT showed ischemic lesions in three patients and cerebral MRI con irmed ischemic stroke in all four patients. As part of the etiological assessment of ischemic stroke in a postpartum woman, Carotid dissection was investigated by ultrasonography of the vessels of the neck. the dissection was shown in two patients. Cervico‑cerebral angio‑MRI con irmed the etiological diagnosis in all patients. The patients were put on anticoagulants at a curative dose with a favorable evolution each time. Conclusion: Carotid dissections are frequent etiologies of stroke in young subjects. In addition to traumatic causes, effort during childbirth can also be a cause of etiology